Joint Replacement (Arthroplasty)

Treatment for severe joint pain


By Brandie Umar, Executive Director of ContentLast modified: December 22, 2011



Joint Replacement (Arthroplasty) Defined

Painful joints can greatly impair a person’s quality of life. Whether caused by years of wear and tear, arthritis, a degenerative or genetic condition, or diseases like cancer, pain in the joints limits mobility and can lead to other medical problems such as obesity.

Joints are two bones that come together and are connected by tissue, ligaments and muscle. The complete joint allows vertical and horizontal movement in the limb. In between the two bones that form the joint is cartilage - a protective tissue that prevents friction between the bones and allows smooth movement inside the joint.

Joint pain is caused by an inflammation in the joint, an injury to the joint, damage to the cartilage or to the supportive ligaments, viral infections and diseases or strain on the joints from over-use, as is the case with athletes, or the pressure caused by supporting excess weight.

Joint replacement (Arthroplasty) is the surgical repair of a damaged, stiffened joint in order to restore movement. This orthopedic procedure works by removing or repairing the damaged joint and replacing it with a prosthetic device that replicates the movement and stability of the joint.

Normally used to relieve joint pain in the shoulder, knee and elbow, arthroplasty can also be used on smaller joints in the fingers and toes. Arthritis is the most common cause of joint problems requiring arthroplasty orthopedic surgery.


A Good Candidate For Joint Replacement (Arthroplasty)

If you suffer from serious, debilitating joint pain, then you may be a good candidate for joint replacement (arthroplasty). Many patients have trouble with daily activities that involve walking. Candidates generally have pain so severe, it wakes them up at night, and find no relief from arthritis medications such as ibuprofen or naproxen.

Along with the above symptoms, a full orthopedic exam (including a weight-bearing x-ray) is necessary to determine if you are in fact a good candidate for joint replacement (arthroplasty). 

Preparing For Joint Replacement (Arthroplasty)

Preparing for joint replacement (arthroplasty) is a very important step. This is a major surgery that requires some planning to be done beforehand to ensure a seamless recovery process.

Orthopedic surgeons recommend quitting smoking at least 6 weeks prior to the surgery date, to promote healthy blood flow for quick healing and rehabilitation. Patients should also avoid alcohol 48 hours before the procedure. Overweight or obese patients are advised to lose weight  and eat a healthy, balanced diet in the weeks leading up to the operation.

Some patients might also benefit from pre-surgery exercises. These help strengthen the body for recovery and also can prepare the patient for upcoming physical therapy post-op. Patients should check with their doctor for a recommended exercise plan.

It's also highly suggested that patients prepare their home for recovery ahead of time as well. Prepare and freeze food, set up a recovery room, and shop for anything that may make your life easier during joint replacement (arthroplasty) recovery. For more information, ask an orthopedic surgeon.

Joint Replacement (Arthroplasty) Procedure

Joint replacement (Arthroplasty) can either be performed by joint resection, interpositional reconstruction or total joint replacement. All procedures involve the use of a tiny camera, inserted through a small, once centimeter incision. The arthroscopic camera is attached to a television monitor, where the orthopedic surgeon can see an image of the joint.


Joint Resection

Joint resection is the lesser-used method of arthroplasty as the operation, while relieving pain, this procedure often leaves joints unstable. Joint resection is literally that: a portion of bone from the damaged joint is removed creating a gap in between the joint socket and the bone. This space increases the motion in the joint however, overtime scar tissue fills the newly created space and the same problem can reoccur as the space in the joint narrows.


Interpositional Reconstruction

Interpositional reconstruction is a slightly more complicated method of arthroplasty but is the preferred method of many orthopedic surgeons, as the surgery rarely needs repeating. As with joint resection arthroplasty, a piece of bone is removed. Using the interpositional reconstruction arthroplasty method, surgeons fill the gap with a prosthetic disk, preventing scar tissue build up.

When either repair method of arthroplasty fails, total joint replacement is the next treatment option.

 
Total Joint Replacement

Total joint replacement is most frequently used to replace knee, shoulder and hip joints. The procedures for hip replacement, knee replacement and shoulder replacement vary slightly, however in all joint replacement procedures, orthopedic surgeons can use a plastic, metal or combination prosthetic to replace the joint. The prosthetic device will be cemented into the joint, especially in the elderly or patients with weak joints, or held in place with a prosthetic designed to connect to the natural bone.

On average, 90% of total joint replacement procedures are successful in re-establishing movement in the joint and relieving pain. Elderly patients who undergo total joint replacement surgery can expect the replacement joint to last a lifetime, however, as prosthetic joints last between 10-15 years depending on the stability of the joint and the material used, younger patients who have joint replacement surgery can expect to need a second surgery to replace the prosthetic.

Recovering From Joint Replacement (Arthroplasty)

Recovering from joint replacement (arthroplasty) involves many steps and requires a major commitment from the patient.

Immediately following the joint replacement (arthroplasty) procedure, patients are required to stay in the hospital for a few days to a couple of weeks, depending on the health of the patient and the type of surgery performed. During the hospital stay, the goal is to get the patient moving as soon as possible, in order to avoid risks like blood clots and pneumonia. With the help of surgeons, nurses and walking aides, patients will be encouraged to walk as much as they can tolerate.

After the hospital stay, patients will be closely monitored at home, and required to start physical therapy. These exercises will be carefully planned by the physical therapist, and shouldn't be too strenuous. In the beginning stages of recovery, range of motion and walking are the main focus for physical therapy, followed by strength and function training after the joint has fully healed.

Recovering from Joint Replacement (Arthroplasty) takes a lot of dedication and patience; improvement is generally slow and can take several months to regain normal strength and function of the joint.

Risks And Side Effects Of Joint Replacement (Arthroplasty)

The risks and side effects of joint replacement (arthroplasty) are: Heart attack, stroke, blood clots, pneumonia, urinary tract infections (UTI), bone fractures, nerve and blood vessel damage, infection, dislocation of the joint, persistent pain, immobility, and weakness.

There are also long-term risks involved with joint replacement (arthroplasty), which include a loosening and/or wearing down of the prosthetic components. These risks are common, and many times require additional surgery to repair the issue.













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This article was written by the medical research team at WhereismyDoctor.com
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